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- Lane M. Robson, MD*
- *Director of Pediatric Nephrology, Director of Continuing Medical Education, The Children’s Hospital, Greenville Hospital System; Clinical Associate Professor, University of South Carolina School of Medicine, Greenville, SC.
IMPORTANT POINTS
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Daytime wetting should be considered a problem in a child who is older than 4 years of age or in a child who previously was continent.
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Urge syndrome is a common cause of wetting in preschool-and elementary-age children and presents with daytime and nighttime wetting, increased frequency of voiding, urgency, and squatting behavior.
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If a child who has a urinary tract infection continues to wet or has other symptoms of voiding dysfunction despite successful treatment of the infection, another cause of daytime wetting should be suspected.
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Most causes of daytime wetting can be determined by taking a thorough history, performing a complete physical examination, and obtaining a urinalysis. Ultrasonography of the kidney and bladder is a helpful noninvasive investigation.
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Management considerations for patients who have urge syndrome include a regular voiding routine, good posture during voiding, physiotherapy, prevention or treatment of urinary tract infection, and an anticholinergic medication.
Introduction
Diurnal enuresis (daytime wetting) is a common childhood problem that has a variety of causes, the majority of which can be determined by taking a thorough history, performing a complete physical examination, and obtaining such noninvasive tests as a urinalysis and ultrasonography of the kidney and bladder.
Definition
Diurnal enuresis is an unintended leakage of urine during waking hours in an individual old enough to maintain bladder control. Primary diurnal enuresis is incontinence that persists beyond the age when a child otherwise would be expected to be toilet trained. Secondary diurnal enuresis is incontinence in a child who was toilet trained successfully and experienced at least 3 consecutive months of dry days.
Daytime wetting should be considered a problem in a child older than 4 years of age who wets on most days, a child who previously was continent, or a child whose parents are concerned about the problem, regardless of the child’s …
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